Malignant salivary gland tumours: treatment outcomes from a tertiary referral centre in the UK.

Salivary gland malignant tumours are a complex and highly variable pathological group. Their diagnosis can be challenging, and management is guided by multidisciplinary teams. This project aimed to establish clinicopathological and sociodemographic features that significantly impacted overall disease-free or progression-free survival in patients diagnosed with malignant salivary gland disease between 2010 and 2019 in a tertiary referral centre. In total, 86 patients were included for analysis, with a female:male gender ratio of 1.3:1. Mean age at diagnosis was 57.7 years. Mucoepidermoid carcinomas constituted almost 25% (n = 20) of all cases, with adenoid cystic carcinomas (20%, n = 17) and acinic cell carcinomas (17.5%, n = 15) being the next most frequently diagnosed. The parotid gland was the most frequently affected site (80.2%, n = 69). Perineural and lymphovascular invasion, and a maximum tumour dimension of ≥4 cm were highly associated with the decision to provide a neck dissection as part of treatment. Involved margins, extracapsular spread, and lymphovascular and perineural invasion were associated with the need for adjuvant treatment. However, no factors remained statistically significant on multivariate analysis. This retrospective service evaluation demonstrates the difficulty of predicting treatment outcomes for patients diagnosed with malignant salivary gland disease.

Active learning in head and neck trauma: outcomes after an innovative educational course.

Excellence in teaching and learning is fundamental to the provision of quality training for doctors and for this a sound knowledge of the principles of adult learning theory is important. We present an educational course in head and neck trauma skills for emergency medicine (EM) registrars, using the pedagogical principle of active learning. Our aim was to provide trainees with skills in the evaluation and management of hard and soft tissue injuries to the head, neck, and mouth. Active learning has been shown to provide a superior experience in classrooms, creating a 'deep' understanding of the material. To maximise learning, we used these principles to develop small group seminars led by a diverse range of teachers that allowed trainees to acquire hands-on skills. Questionnaires that were completed before and after the course showed an appreciable educational impact. We conclude that innovative teaching methods facilitate the sharing of knowledge that will benefit patient care.

Handle-On-QOL: a dedicated quality of life resource following the diagnosis and treatment of head and neck cancer.

Measuring quality of life (QOL) after head and neck cancer (HNC), is rapidly becoming the standard of care. The Head and Neck Database Listing Evidence on QOL (Handle-On-QOL) is a dedicated QOL resource that includes articles published from 1982 onwards. The aim of this study was to assess the completeness of Handle-On-QOL, when compared with other non-specific search engines. Six years were selected at random; 1982, 1990, 1998, 2003, 2006, 2016. Four search engines were used (Medline, EMBASE, CINAHL, PsycINFO). Reporting followed PRISMA methodology. A total of 595 papers were assessed, of which 200 met the inclusion criteria. 186 papers were present on Handle-On-QOL, 243 were found on Handle-On-QOL for these six years, but not identified in the other searches, and 14 were missing from Handle-On-QOL. A search using standard engines generated a large number of irrelevant papers. Handle-On-QOL provides a comprehensive and accurate reflection of articles published using questionnaires to report QOL following HNC. This web-based repository (http://www.handle-on-qol.com) acts as a quick reference point for clinicians and researchers.

Our experience of a nurse-led oral and maxillofacial surgical clinic in a tertiary centre: two years on.

We describe our two-year experience of a nurse led clinic (NLC) in a tertiary centre oral and maxillofacial surgical (OMFS) department. The clinic is run by a specialist nurse, in parallel with a consultant's clinic and focuses on the management and review of non-malignant lesions. Increased clinical flexibility, reduced waiting times, and tailored educational resources have contributed to an improved experience for the patients.

How practices can facilitate access for the gypsy traveller community.

Gypsy travellers have poor health in comparison to the UK average. They may struggle to access emergency and routine dental care because of social, educational and cultural barriers. General dental practitioners can facilitate better oral health within the community by improving access, which may require some adaptation to conventional practice. This paper discusses the experiences of a practice within West Oxfordshire and highlights areas in which the authors have found small modifications to aid appointment attendance and patient motivation. Primary care dental practitioners come across a wide variety of patients from very diverse backgrounds. Following a year working in West Oxfordshire, one group of patients has particularly stood out - the travelling community. The term 'traveller' or 'gypsy' refers to 'persons who wander or travel for the purpose of making or seeking their livelihood (not persons who move from place to place without any connection between their movements and their means of livelihood)' and includes those who live permanently or temporarily in settled housing. There are many different socio-cultural groups within this broad definition, including Romany Gypsies, Irish Travellers, Scottish Travellers and Eastern European Roma Communities.